Department of Health Sciences, Lund University, Lund, Sweden.
Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
Top Stroke Rehabil. 2023 Jan;30(1):21-31. doi: 10.1080/10749357.2021.1978631. Epub 2021 Sep 30.
The ABILHAND questionnaire is recommended to assess perceived manual ability after stroke; however, more knowledge on interpretability is needed to improve the clinical applicability.
To determine clinically meaningful cutoff scores for different levels of perceived manual ability, assessed by ABILHAND, corresponding to established observed and perceived upper extremity assessments post stroke.
This cross-sectional study, part of the Stroke Arm Longitudinal Study (SALGOT) at the University of Gothenburg, included 80 participants with upper extremity impairments after stroke. The self-reported upper extremity functioning was assessed with ABILHAND and Stroke Impact Scale Hand (SIS Hand), and the observed functioning was assessed by Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) at 3 months after stroke. Receiver operating characteristic curve, sensitivity, and specificity analyses were used to determine the cutoffs.
The overall discriminating accuracy was excellent (AUC > 0.90) for most of the cutoffs and sensitivity and specificity values ranged from 0.73 to 1.0. The ABILHAND cutoff score 1.78 discriminated well between low and good functioning resulting in a 95% match with SIS Hand and 87.5% match with ARAT and FMA-UE.
The determined cutoff scores of the ABILHAND, validated through established upper extremity assessments, will provide a useful tool to clinicians when interpreting the logit scores and when selecting individualized treatment options. ABILHAND matched well with self-reported SIS Hand, but discrepancies found with observed scales implies that self-perceived assessments should be complemented with observed assessments.
ABILHAND 问卷被推荐用于评估卒中后患者的感知手功能；然而，为了提高临床适用性，需要更多关于可解释性的知识。
确定 ABILHAND 评估的不同感知手功能水平的临床有意义的截断分数，与卒中后观察到和感知到的上肢评估相对应。
这是哥德堡大学 Stroke Arm Longitudinal Study（SALGOT）的一项横断面研究，纳入了 80 名上肢功能障碍的卒中患者。自我报告的上肢功能通过 ABILHAND 和卒中影响量表手部（SIS Hand）进行评估，观察到的功能通过卒中后 3 个月的 Fugl-Meyer 上肢评估（FMA-UE）和动作研究上肢测试（ARAT）进行评估。使用受试者工作特征曲线、灵敏度和特异性分析来确定截断值。
大多数截断值的整体判别准确性都很好（AUC > 0.90），灵敏度和特异性值范围为 0.73 到 1.0。ABILHAND 截断分数 1.78 很好地区分了低功能和高功能，与 SIS Hand 的匹配度为 95%，与 ARAT 和 FMA-UE 的匹配度为 87.5%。
通过既定的上肢评估验证的 ABILHAND 截断分数将为临床医生在解释逻辑得分和选择个体化治疗方案时提供有用的工具。ABILHAND 与自我报告的 SIS Hand 匹配良好，但与观察到的量表之间的差异表明，自我感知的评估应与观察到的评估相结合。
